Book Review: Egg Freezing, Fertility and Reproductive Choice - Negotiating Responsibility, Hope and Modern Motherhood
Over the last decade the number of women who have opted to freeze their eggs for social reasons has risen exponentially. Nevertheless, there is still much to learn about why women decide to freeze their eggs, how they perceive the risks and benefits of this reproductive option, and what effect egg freezing has on the subsequent life trajectory of these women and society in general. Dr Kylie Baldwin, senior lecturer at De Montfort University, skillfully explores these issues in her new book, 'Egg Freezing, Fertility and Reproductive Choice: Negotiating Responsibility, Hope and Modern Motherhood'.
The first half of the book examines the social and ethical dilemmas that the practice of social egg freezing can create. Some regard social egg freezing as the next 'reproductive revolution', one in which women will be freed from the constraints of age-related infertility. However, this viewpoint is overly simplistic and does not acknowledge the complex and problematic issues that have arisen from the use of this 'fertility extension' tool.
Dr Baldwin suggests that age-related infertility is no longer being viewed as a natural part of the ageing process and is instead being reframed as a disease that can be 'fixed'. Egg freezing technology therefore has the potential to be marketed in the same way as anti-wrinkle cream, with commercial companies exploiting society's fear of ageing for financial gain.
Some individuals believe that egg freezing opportunities will allow women to control their fertility and thereby narrow the gender divide associated with reproductive choice and the timing of parenthood. However, this technology creates a situation where women may now be expected to 'manage' their reproductive lifespan, which, as Dr Baldwin points out, creates a 'highly gendered emotional burden' which men do not have to carry.
While there has been much debate in the media about the sociological impact of social egg freezing, much less attention has been paid to the real-life experiences of women who have used this form of reproductive technology for social reasons. Dr Baldwin has attempted to address this imbalance through her research, in which she interviewed 31 women about their personal experiences of social egg freezing. The results of this research heavily underpin the second half of the book.
It was striking to hear that the vast majority of participants did not freeze their eggs in order to actively delay motherhood. Indeed, most women felt that their social circumstances, particularly the lack of a serious partner, had prevented them from becoming a mother at the 'optimum time'.
These women often rejected the option of pursuing fertility treatment with a sperm donor because it would necessitate letting go of their 'dream family', which typically consisted of a committed male partner and children who were genetically related to both parents. Egg freezing therefore offered these women the possibility of having a child with shared genetic parentage in the future and reduced the pressure to engage in 'panic partnering'.
Many women found that they experienced a period of 'mourning' once they embarked on the egg freezing process. This emotional response seemed to be provoked by the fact that these women did not fundamentally want to freeze their eggs but instead felt that their social circumstances left them with no other option.
I was struck by the fact that many of the women in the study underestimated the risks associated with the medical aspects of their treatment and were subsequently shocked by the side effects that they experienced. Some 16 percent of the participants developed ovarian hyperstimulation syndrome (OHSS) - a potentially life-threatening condition, following their egg collection. It appears that the risks associated with egg freezing were often not seriously considered by the participants due to the similarities between the egg freezing procedure and general IVF treatment. One woman commented: 'It's the same as doing IVF. If it was super dangerous then people wouldn't be doing it.'
One of the most unique aspects of the book is that it shines a light on what happens after the egg freezing procedure has taken place. This is a perspective that is rarely heard and made for some captivating reading. Many women described feeling a sense of empowerment immediately after the procedure. They felt emboldened by the fact they had taken proactive steps to maximise the chance of having a genetically-related child in the future and cited that they would feel less regret if their attempts to have a child were ultimately unsuccessful.
Nevertheless, this sense of empowerment did not always reduce the sense of urgency that participants felt towards finding a partner, which may reflect the fact that there is no guarantee that frozen eggs will result in a healthy baby. A small number of the participants felt relatively optimistic about their chances of achieving a successful pregnancy with their frozen eggs. However, the vast majority of women held a more pessimistic view.
One big decision the participants had to grapple with was whether to disclose the fact they had frozen eggs when forming a new romantic relationship. Some women viewed their frozen eggs as an asset and wanted to let their new partner know about their 'reproductive capital'. Conversely, some women preferred to keep it secret as they feared that their new partner might use these eggs as an excuse to delay parenthood. This decision appears to be something of a minefield as some instances of disclosure resulted in the prompt ending of the relationship.
Overall, this is a thoroughly fascinating book which would be of great interest to academics within the field of sociology and medical ethics, as well as to women who are seriously considering freezing their eggs for social reasons. I also believe that individuals working in the field of reproductive medicine would benefit greatly from reading this book. A greater awareness of the challenges associated with social egg freezing may enable fertility clinics to improve the support that they offer to these patients.